Provider Demographics
NPI:1184668865
Name:KLAUSNER, MARI (MD)
Entity Type:Individual
Prefix:
First Name:MARI
Middle Name:
Last Name:KLAUSNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 SUTHERLAND AVE
Mailing Address - Street 2:STE 110
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919
Mailing Address - Country:US
Mailing Address - Phone:865-525-4333
Mailing Address - Fax:865-212-8879
Practice Address - Street 1:2210 SUTHERLAND AVE
Practice Address - Street 2:STE 110
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919
Practice Address - Country:US
Practice Address - Phone:865-525-4333
Practice Address - Fax:865-212-8879
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01061510A207RI0200X
TN47050207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200810790Medicaid
IN499500 FFFFMedicare PIN
TN103I444075Medicare PIN
155386Medicare UPIN